Unacceptable Delays in Paying needed CPP Disability Benefits hurt Canadians with Severe and Permanent Disabilities

Following a recent and disturbing assessment of the CPP process, Canada’s Auditor General, Michael Ferguson, criticized the federal system of paying disability benefits for being generally inefficient and beleaguered by paperwork. As a result, many Canadians with serious disabilities, who have paid into the system for many years and are now in genuine need of support, are forced to wait far too long for payment or are having their legitimate claim denied altogether.

The objective of CPP disability income is to subsidize part of the income for Canadians who are no longer able to work due to a long-term or severe disability and who rely on this benefit to pay for day-to-day expenses.  A severe disability is one that prevents a person from regularly pursuing gainful employment. Individuals may be able to work in a limited capacity and still be eligible for CPP disability benefits.

Many of the people impacted by the delay in receiving disability benefits have a terminal condition such as cancer.  Only seven per cent of terminally ill applicants applying for disability payments were given a decision on their application within the recommended 48 hours.  Slightly more than half of Canadians suffering from chronic conditions received a decision within the prescribed 30 day timeframe.

Part of the problem is that the process is not web-based and is quite antiquated by today’s standards; an inordinate amount of paperwork must be completed before payments are approved and disbursed. In fact, the application kit contains five forms and 42 pages, and can take several months to finish.

Another concern with the process is a lack of effective procedures to ensure that decisions are consistent and fair.  The recent audit revealed that about one-third of applicants who were initially denied disability benefits were later determined to be eligible.

Approximately 60 per cent of initial applications for disability benefits are refused. In addition to the voluminous paperwork, some of reasons why it can be difficult to submit a successful application for benefits include:

• unclear guidelines; 
• the inability to obtain the required medical and employment history documentation; and
• difficulty reaching service staff to help with the application process.

In 2013, the Conservative government (without prior discussion with administrators who oversaw the prior appeals system), established the Social Security Tribunal.  The intention of this new tribunal was to reduce the ballooning backlog of applicants who had been denied their application for benefits a second time and wished to appeal.  However, this tribunal has been  criticized for being understaffed and lacking sufficient resources.  The result is that applicants frequently wait a frustratingly long time to hear a decision from the tribunal: on average, 884 days.  Additionally, about 38 per cent of people appealing to the tribunal wait more than a year for a decision. This is a far cry from the service standard for the Department of Employment and Social Development which set a goal of 120 days for a decision on disability applications.

Under the current ‘revised’ Tribunal system, applications being appealed are heard by a single member, in contrast to the previous system where an appeal was reviewed by a three member panel typically consisting of a medical specialist, lawyer and lay person.  A single person deciding an appeal is disadvantaged in terms of their perspective on complicated cases. Also, the decisions made by different individuals single-handedly are less likely to be consistent.

Michael Prince, a Professor of Social Policy at the University of Victoria who has often written on disability policy in Canada, wrote in The Globe and Mail (July 2014) that Canadians with disabilities have lost some rights when applying for disability benefits. The new Tribunal is legally allowed to summarily dismiss appeals that are believed to have no reasonable chance of success.  Further, applicants do not have the right to plead directly to a tribunal member, which Mr. Prince criticises for failing in procedural fairness when there is an issue of credibility.  Applicants may be permitted a hearing (based on the tribunal member’s discretion) by teleconference, a video conference, or by means of written documents.

In response to the delays and inefficiencies in the disability benefit claims process, the Minister of Families, Children and Social Development, Jean-Yves Duclos, stated publicly that he has instructed his department to restructure and speed up the decision-making process for CPP disability applicants, who are described as some of Canada’s most vulnerable citizens.   Certainly, playing ‘catch-up’ and fairly assessing disability benefit applications that continue to be submitted will not be a simple or quick process.  In the meantime, many people with serious disabilities and their families will be left waiting and insecure about their future finances.